Volume 87  ·   Issue 07  ·  2007

Objective to investigate the correlation between pulse pressure (PP) and pulse pressure index (PPI) and stroke in rural areas. Methods A stratified cluster sampling method was used to investigate the epidemiology of 29 970 residents aged 35 years or older in rural areas of Fuxin. A database was established by Epidata3.1, and statistical analysis was carried out by SPSS11.5 software. Results (1) PP in stroke group and non-stroke group, male 65 mm Hg ± 19 mm Hg (1 mm Hg =0.133 kPa) and 52 mm Hg ± 14 mm Hg, 70 mm Hg ± 21 mm Hg and 53 mm Hg ± 17 mm Hg in females; PPI in the two groups were 0.40±0.08 and 0.38±0.07 for males and 0.42±0.08 and 0.39±0.07 for females, respectively. PP and PPI in the stroke group were higher than those in the non-stroke group, and the differences were statistically significant (P<0.01). (2) With the increase of PP level and PPI level, the prevalence of stroke in different genders showed an increasing trend (trend χ 2 test P<0.01). (3) ROC curve analysis: The area under ROC curve of males was 0.720 (95% CI 0.694~0.746) and 0.581 (95% CI 0.553~0.610) when the optimal boundary value was taken; The female PP was 0.755 (95% CI 0.727-0.784), and the PPI was 0.681 (95% CI 0.583-0.650); The difference of area under PP and PPI curves was statistically significant (P<0.01). Conclusion Both pulse pressure and pulse pressure index are related to stroke and are risk factors of stroke. Pulse pressure is better than pulse pressure index in predicting the prevalence of stroke.

Objective to compare the difference of intestinal mucosal permeability between patients with different types of cholelithiasis and normal subjects. Methods According to the intraoperative stone section structure, 56 patients with cholelithiasis were divided into cholesterol stone group (n =15) and bile pigment stone group (n =41), and 17 healthy volunteers were used as the control group. The excretion rate of 99Tmc-DTPA in 24 hours urine, namely intestinal mucosal permeability, was compared between the three groups by oral administration of 99Tmc-DTPA. Results The excretion rate of 99Tmc-DTPA in 24 hours urine was 4.5%±3.4% in the control group, 5.0%±3.6% in the cholesterol stone group and 10.5%±6.9% in the bile pigment stone group. The excretion rate of 99Tmc-DTPA in urine was significantly higher in the bile pigment stone group than in the control group (F value 7.62, P<0.05), but the difference between the cholesterol stone group and the control group was not statistically significant (F value 2.16, P>0.05). Conclusion The intestinal mucosal permeability of patients with bile pigment stone was significantly higher than that in the control group, and the increase of intestinal mucosal permeability may be a cause of bile pigment stone.

Objective to investigate the reconstruction method of lumbar spine and pelvis with TSRH-3 d internal fixation after sacrectomy and its effect.Methods 28 patients with lumbosacral bone tuberculosis, including 117 cases of L5-S,24 cases of L5-S,34 cases of L5-S,2 cases of S1-2; The results were followed up for 8~48 months, and the recent results were satisfactory. 2 cases had dysuria, 1 case had cerebrospinal fluid leakage, 2 cases had incision infection and delayed healing. Postoperative lumbosacral pain and lower limb root symptoms were significantly relieved, and normal weight bearing and walking were restored. There were no broken nails, rods or loose screws. X-ray examination showed no enlargement of nail hole, pelvic cohesion and lumbar vertebra movement (L5 sinking). Conclusion Lumbosacral tuberculosis removal and reconstruction is beneficial to maintain lumbar vertebra and pelvic stability, relieve pain and preserve the walking function of patients.

Objective to summarize the clinicopathological characteristics, surgical methods and prognostic factors of thymoma. Methods 66 patients with thymoma were treated according to Masaoka's clinical stage and tumor growth, including median thoracic incision or anterolateral thoracic incision, complete or palliative thymoma resection. Results Among 66 thymoma cases, 14 cases (21.2%) were accompanied by myasthenia gravis, 29 cases (43.9%) were treated with Masaoka stage Ⅰ, 16 cases (24.2%) were treated with Masaoka stage Ⅱ, 19 cases (28.8%) were treated with Masaoka stage Ⅲ, and 2 cases (3.0%) were treated with Masaoka stage Ⅳ. Total thymus and thymoma resection was performed in 14 cases, simple thymoma resection in 40 cases, partial tumor resection in 5 cases, thoracotomy and exploratory tumor biopsy in 6 cases, cervical lymph node biopsy in 1 case, 7 cases were treated with pericardial resection, 2 cases were treated with superior vena cava resection, 1 case was treated with partial pulmonary resection, 1 case died within 30 days after operation, 24 cases were treated with adjuvant radiotherapy, 2 cases were treated with adjuvant chemotherapy, and 4 cases were relapsed.

Objective to evaluate the effectiveness of combined anti-inflammatory and immunostimulation in the treatment of severe sepsis.Methods A multicenter, prospective, randomized and controlled method was used in this study.A total of 433 patients were enrolled in this study.Patients with severe sepsis (Marshall score 5-20) in ICU were enrolled and randomly divided into control group:conventional treatment; Treatment group 1 (stage 1): conventional treatment + ulinastatin 300,000 U/day, α 1 thymosin (Maipuxin) 1.6 mg/d for 7 consecutive days; Treatment group 2 (stage 2): conventional treatment + ulinastatin 600,000 U/day, Maipuxin 3.2 mg/day for 7 consecutive days, 28 d and 90 d prognosis and other efficacy evaluation. Results There was no statistically significant difference in prognosis and other efficacy evaluation indexes between the treatment group (treatment group 1) and the control group in 91 cases in stage 1. In stage 2, compared with the control group (intention-to-treat analysis), the 28 d mortality rate of the treatment group (treatment group 2) was 25.1% vs 38.3% (P =0.0088), 90 d mortality rate was 37.1% vs 52.1% (P =0.0054), 28 d APACHE Ⅱ score was 12.7±9.4 vs 14.3±9.2 (P =0.0384), 28 d Monocyte HLA-DR/CD14+ (51.7±26.5) % vs (40.1±22.0) % (P =0.0092). Other efficacy evaluation indexes, such as the number of days of treatment in ICU, the number of days of ventilator use and the time of antibiotic use, were not statistically significant between the two groups. Conclusion The treatment plan in this study can significantly improve the prognosis of patients with severe sepsis at 28 days and 90 days, and has positive promotion value; The efficacy of treatment is dose-dependent, and the optimal dose needs to be further discussed.

Objective to investigate the clinical value of negative expiratory pressure (NEP) technique in the detection of expiratory flow velocity limitation (EFL) in patients with chronic obstructive pulmonary disease (COPD). Methods EFL was detected by NEP technique in 54 patients with COPD and 8 patients with COPD who could not complete routine pulmonary function examination. Results EFL was detected in 41 cases of 54 patients with COPD. The percentage of forced expiratory volume in 1 second (FEV1%) in group 2 (55.71% ± 11.77%), group 3 (41.21% ± 13.69%) and group 4 (29.84% ± 11.65%) was lower than that in group 0 (83.76% ± 16.44%). Multiple stepwise regression analysis showed that the 5-point EFL score was the first entry factor and had the best correlation with dyspnea. All 8 patients with COPD could tolerate NEP test. Conclusion Compared with FEV1%, the 5-point EFL score is a more reliable index to evaluate dyspnea in patients with COPD; NEP technique is simple to operate and does not require active cooperation of patients. It can be applied to patients who cannot complete routine pulmonary function tests.

Objective to analyze and investigate the incidence of primary central nervous system tumors in children.Methods the age and sex distribution of 763 cases of primary central nervous system tumors in children under 18 years old were retrospectively analyzed.Results the average age of 763 cases was 12.7 years old, and the ratio of male to female was 1.56:1.Among them, intracranial tumors accounted for 93.4% (713/763) and spinal cord tumors accounted for 6.6% (50/763). Among intracranial tumors, compared with subtentorial tumors (30.5%, 233/763), supratentorial tumors (including pineal-tetraassic region) were the main tumors (62.4%, 476/763). Among these cases, 688 cases were diagnosed by pathology and 35 cases were diagnosed by clinical.The five most common tumors were astrocytic tumors (25.7%, 177/688), craniopharyngioma (12.8%, 88/688), medulloblastoma (9.3%, 64/688), germ cell tumors (8.9%, 61/688), It can treat the lesions comprehensively while preserving the function of the nervous system as much as possible.

Objective to analyze the imaging and clinical predictive indexes of progressive cerebral hemorrhage. Methods 98 patients were diagnosed as spontaneous intracerebral hemorrhage (ICH) by computed tomography (CT) within 4 h after the onset of the disease, and CT was repeated 24 h later to understand the occurrence of hematoma progression. Firstly, the significance between possible risk factors and early hematoma progression was tested, and then the regression equation was obtained by multiple stepwise regression. Results The incidence of progressive cerebral hemorrhage was 26.5%. The effective predictive indexes were: uneven hematoma density on CT, the degree of consciousness disorder of patients at the time of consultation, the time from the first CT diagnosis and the history of cerebral infarction. At the same time, the characteristic "hematoma growth line" on CT has important predictive value for progressive cerebral hemorrhage. Conclusion There are clear predictive indexes for progressive cerebral hemorrhage. Uneven hematoma density is of great significance for the prediction of progressive cerebral hemorrhage.

Objective to evaluate the association between interleukin (IL) -1 gene polymorphism and the incidence of ankylosing spondylitis (AS). Methods the data from published literature were synthesized by meta-analysis. All case-control studies related to AS were collected by searching Pubmed, EMBASE, Cochrane Library and China Biomedical Literature Database (CBM). Inclusion criteria: Included literature contents involved case-control studies of interleukin (IL) -1 gene polymorphism and AS; AS diagnosis was made by a rheumatologist according to the New York Diagnostic Criteria revised in 1984; The raw data provides allele frequencies and/or genotype frequencies; Results (1) Six articles were included by comprehensive search, a total of 9 study populations, and the overall data showed obvious heterogeneity in combined statistics. After stratification according to Caucasian race and Mongolian race, there was homogeneity among the studies in the subgroups. (2) Meta-analysis showed that the number variable tandem repeat (VNTR) polymorphism allele 2 in IL-1RN intron 2 increased frequently in Caucasian AS patients, and the allele OR =1.52 (95% CI =1.26-1.84, P<0.01), and the corresponding genotype OR =1.33 (95% CI =1.04-1.70, P<0.05); However, the frequency of this allele in Mongolian AS patients was lower than that in the control group, OR =0.55 (95% CI =0.38-0.81, P<0.01), OR =0.51 (95% CI =0.34-0.77, P<0.01). (3) The frequency of the minor allele T of IL-1A-889 C>T (rs1800587) was higher in Caucasian AS patients, OR =1.36 (95% CI =1.12-1.66, P<0.01), and OR =1.56 (95% CI =1.20-2.03, P<0.01) of the corresponding genotype C/T + T/T, but the difference was not statistically significant in Mongolian population. (4) In Caucasian population, the frequency of the minor allele G of IL-1F8 SNP rs1900287 increased in AS patients, OR =1.22 (95% CI =1.04-1.44, P<0.05). Conclusion AS a disease with complex traits, the genetic susceptibility factors of AS may be related to IL-1 gene polymorphism, and the related polymorphism loci are IL-1

The research of stem cells or progenitor cells is one of the most vigorous research fields in life science.In many stem cell researches, the research of endothelial progenitor cell (EPC) is attracting more and more attention, especially EPC in peripheral blood. Because of its important role in the outcome and treatment of human diseases, many scholars have studied its origin, characteristics and influence on diseases.

Objective to investigate the changes of integrin gene expression in the heart of sepsis rats and the related mechanisms of heart injury caused by sepsis.Methods Twelve male Wistar rats aged 3 months were randomly divided into two groups.The sepsis model was established by cecal ligation and acupuncture method or sham operation as the control group.The hearts were quickly harvested 24 hours after surgery, and the hemodynamic parameters of the rats were measured by Langendorff isolated rat heart perfusion method, then pathological examination was performed, and then the expression differences of integrin family genes in the heart tissues of the two groups were detected by oligonucleotide gene microarray. Results There were no obvious pathological changes in the heart of sepsis rats, but the hemodynamic parameters such as cardiac output and stroke volume, heart rate, left ventricular developmental pressure and left ventricular end diastolic pressure were significantly decreased, suggesting that the rat heart was in a state of depression; Gene microarray detection showed that the expression of 20 of 24 integrin subunit genes was up-regulated more than twice as compared with the control group, and the core subunit α v and β 2 integrin genes were up-regulated obviously, while the integrin β 1 gene expression was relatively insufficient. Conclusion The expression of integrin genes in the heart of septic rats is dysregulated, and the upregulation of α v and β 2 integrin genes may promote the heart injury caused by inflammatory mediators; The relative insufficient expression of integrin β 1 gene may be related to cardiac insufficiency in rats.

Objective to investigate the effect of perfluorocarbon (PFC) vaporization inhalation on the apoptosis of small intestinal mucosal epithelial cells in piglets with lung injury induced by lung lavage. Methods 18 healthy piglets were randomly divided into three groups: VMV group (PFC vaporization inhalation), CMV group (conventional mechanical ventilation) and sham operation group. The apoptosis index of small intestines in each group was detected by TUNEL method, and apoptosis genes BAX and bcl-2 were determined by immunohistochemistry and semi-quantitative RT-PCR method. Results the positive cells in small intestine were mainly distributed in small intestinal villi. The apoptosis rate was 70.6%±3.4% in CMV group and 22.9%±2.3% in VMV group, and the difference between the two groups was statistically significant (P<0.05). The expression of BAX protein in small intestine in VMV group was lower than that in CMV group (P<0.05), and the expression of bcl-2 protein in small intestine in VMV group was higher than that in CMV group (P<0.05). The results of BAX mRNA and bcl-2 mRNA were consistent with the expression of protein in small intestine (P<0.05).

Objective to investigate the effect of suture anchor simple intermittent suture method, suture anchor mattress suture method and Mclaughlin suture method in repairing the injury of supraseptial muscle tendon in rabbits.Methods Forty-five New Zealand rabbits were randomly divided into three groups, 15 in each group.The left supraseptial muscle tendon of the rabbits was cut at the end point with a width of 8 mm, and the supraseptial muscle tendon injury model was established, with the right supraseptial muscle tendon as the control.Group A was sutured with suture anchor simple intermittent suture method; Group B was sutured by suture anchor mattress suture method; Group C was sutured by traditional Mclaughlin suture method. The healing of suprapostial muscle tendon was observed, and the healing rate of animals in each group was compared. Twelve animals were randomly selected from each group and their bilateral scapular band specimens were taken for biomechanical test to measure the healing strength of suprapostial muscle tendon. The other animals were taken from their left scapular band specimens after nitrate decalcification and HE staining for histological observation to observe the healing of suprapostial muscle tendon insertion point. Results 1 animal in each group A and B failed to repair due to infection, and the healing rate was 93.33%; All the animals in group C healed, and the healing rate was 100%. The healing rate of the three groups was tested by χ 2 test, χ 2=1.047, and the difference was not statistically significant (P>0.05). The mean value of the maximum tensile force load after the healing of the suprapostial muscle tendon in group A was (82.4+20.7) N; The mean value of the maximum tensile load in group B was (81.8±20.3) N; The mean value of maximum tensile load in group C was (88.6±17.2) N. The statistical treatment was carried out by analysis of variance (F =0.446, the difference between the three groups was not statistically significant (P>0.05). Histological study showed that the tendon insertion point in group A and B was the tendon of supraseptial muscle directly attached to the lamellar bone, while the tendon insertion point in group C was the structure of supraseptial muscle tendon, cartilage and lamellar bone migrating to each other, but the number of chondrocytes was significantly reduced compared with the normal tendon insertion point. Conclusion There was no statistically significant difference in healing rate and healing strength between suture anchor simple intermittent suture method, suture anchor mattress suture method and Mclaughlin suture method for rabbit supraseptial muscle tendon repair. However, the healing strength after Mclaughlin suture method was slightly greater than the former two, and the histological healing situation was closer to the normal tendon insertion structure.

Objective to observe the effect of ginkgo ketone ester (EGb50) on the expression of inducible nitric oxide synthase (iNOS) in rats with sciatic nerve injury. Methods 156 SD rats were randomly divided into sham operation group, injured control group and experimental group. The right sciatic nerve was severed and sutured in the latter two groups. The experimental group was given EGb50 200 mg · kg-1 · d-1 dissolved in 1 ml normal saline by gavage, while the injured control group was given 1 ml normal saline by gavage. The sham operation group only exposed the right sciatic nerve and did not treat it after operation. The nerves at the distal end of the anastomosis were taken at 1, 3, 7, 14, 21 and 28 days after operation, respectively, and the expression levels of iNOS in the injured nerve were detected by immunohistochemistry and real-time fluorescence quantitative polymerase chain reaction (PCR). Results The mean value of iNOS positive staining absorbance (A) in the experimental group was significantly lower than that in the control group at 3, 7, 14 and 21 days after operation (all P<0.05), and the expression of iNOS mRNA in sciatic nerve in the experimental group was lower than that in the control group at 1, 3 and 7 days after operation (P<0.01). Its mechanism of action to promote nerve regeneration may be related to the inhibition of iNOS expression.

Objective to observe the effects of Nordy, a self-developed lipoxidase inhibitor, on the expression and functional activity of formylated peptide receptor (FPR) in human malignant glioma cell line U87. Methods the effects of Nordy on the expression of FPR in human malignant glioma cell line U87 were observed by indirect immunofluorescence labeling and laser confocal scanning microscopy. FPR agonist N-formylated methionyl-leucine-phenylalanamide (fMLF) activated FPR and then added Nordi. The experiments were divided into the following three groups: ① control group, ② fMLF stimulated group and ③ Nordi treated group. The effects of Nordi on the proliferation and secretion of vascular endothelial growth factor (VEGF) and interleukin-8 (IL-8) induced by FPR activation were detected by tetramethylazolazole salt (MTT) assay, reverse transcription polymerase chain reaction (RT-PCR) and double antibody sandwich enzyme-linked immunosorbent assay (ELISA) respectively. Results Nordi (100 μ mol/L) significantly inhibited the expression of FPR receptor in U87 cells, and at the same time, it significantly inhibited the proliferation and the expression of angiogenic factors VEGF, IL-8 mRNA and protein secretion induced by FPR agonist fMLF (100 nmol/L). After fMLF was applied to U87 cells for 36 h, the levels of VEGF and IL-8 protein were significantly higher than those in the control group (P<0.05), (6.46±0.33) ng/ml and (7.54±0.73) ng/ml, respectively; The levels of VEGF and IL-8 protein were (3.59±0.33) ng/ml and (3.13±0.48) ng/ml, respectively, which were significantly lower than those in the control group (P<0.05). Conclusion Nordi can inhibit the expression of FPR in human malignant glioma cells, the proliferation of tumor-promoting cells after activation of this receptor, and the expression of pro-angiogenic factors VEGF, IL-8 mRNA and protein secretion, suggesting that Nordi can inhibit tumor growth and anti-angiogenesis.

Methods Human umbilical vein endothelial cells (HUVEC) were primarily cultured, and the expression of various receptors of Netrin-1 on them was detected by reverse transcription polymerase chain reaction, and the effects of Netrin-1 on proliferation, migration and tubular structure formation of HUVEC were detected by in vitro experiments, respectively, and the angiogenesis in vivo under different concentrations of Netrin-1 was studied by rabbit corneal neovascularization experiment. Results Only one receptor, UNC5B, was detected on HUVEC. It was found that Netrin-1 was not only a pro-angiogenic factor, but also an inhibitory factor in both in vivo and in vitro experiments, and it showed a promoting effect when the concentration was less than 500 ng/ml, and an inhibitory effect when the concentration was 1000~5000 ng/ml. Among them, the proliferation ability of HUVEC was the strongest when Netrin-1 was 50 ng/ml, and the migration ability of HUVEC was the strongest when Netrin-1 was 100 ng/ml. Conclusion Netrin-1 plays a dual regulatory role of promoting and inhibiting angiogenesis, Where the inhibition is associated with the receptor UNC5B.

Objective to investigate the effect of estrogen on the formation of abdominal aortic aneurysm (AAA) in rats and to investigate the mechanism of estrogen inhibition on abdominal aortic aneurysm. Methods Twenty male Wistar rats were randomly divided into experimental group and control group, respectively. The experimental group was regularly injected with estradiol intraperitoneally, and the control group was regularly injected with normal saline (NS) intraperitoneally, respectively, and the inferior renal abdominal aorta was perfused with elastase to make AAA model. After 14 days, the content of estradiol in serum was detected by radioimmunoassay, and the mRNA and protein expression of matrix metalloproteinase 2, 9 (MMP-2, 9) in aneurysm tissue were determined by immunohistochemistry and Real-Time fluorescence quantitative polymerase chain reaction (Real-Time PCR). Results Compared with the control group, the level of estradiol in the experimental group was significantly increased, The aneurysm dilatation rate was (103±4) % and (172±13) % (P<0.01), the relative expression of MMP-2 mRNA was 0.07±0.04 and 0.22±0.07 (P<0.01), the relative expression of MMP-9 mRNA was 1.4±0.7 and 7.4±2.8 (P<0.01), the expression of MMP-2 was (22±3) % and (50±12) % (P<0.01), and the expression of MMP-9 was (23±2) % and (45±10) % (P<0.01), respectively. Conclusion Estrogen may inhibit the formation of abdominal aortic aneurysm by reducing the mRNA expression, protein synthesis and inflammatory cell infiltration of MMP-2 and 9 during abdominal aortic aneurysm formation.

The invention of the first endoscope has a history of more than 50 years, and it has been recognized by doctors and patients because of its advantages such as less trauma, less complications, fast healing time and low price. However, due to its large volume, poor flexibility and inability to provide three-dimensional images, its clinical application is still limited.

Diabetes mellitus is the main risk factor of cardiovascular disease, which can increase the risk of early onset of cardiovascular disease and death. Physical activity, weight loss and some hypoglycemic drugs can reduce the incidence of diabetes mellitus in patients with increased blood sugar level but not yet reaching the diagnostic criteria of diabetes mellitus.